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BACKGROUND: The current COVID-19 pandemic mainly affects the respiratory system;however, with the increase in cases worldwide, there is evidence of compromise at the cardiovascular level, which can manifest as acute myocardial infarction, myocarditis, pericarditis, myopericarditis, heart failure, cardiogenic shock, vasculitis, deep vein thrombosis, pulmonary embolism, ischemic stroke, acute arterial insufficiency, arrhythmias, and sudden death. CLINICAL CASE: A 70-year-old male patient who simultaneously presented multisystemic thrombosis manifested by cerebral vascular event, pulmonary thromboembolism, acute myocardial infarction and acute arterial insufficiency in the context of SARSCoV-2 pneumonia. CONCLUSION(S): In patients with COVID-19 there is a high thrombogenic potential secondary to blood stasis, hypercoagulability and endothelial dysfunction, which worsens the prognosis and increases mortality, mainly in patients who require ICU stay, so an adequate thromboprophylactic or anticoagulant scheme and follow-up in the convalescent phase must be provided to detect sequelae associated with COVID-19.Copyright © 2022 Comunicaciones Cientificas Mexicanas S.A. de C.V.. All rights reserved.
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Plants traditionally used for medicinal use could be an alternative against SARS-CoV-2. In this study, the binding energy of 10 bioactive compounds of plants used in Mexico against COVID-19 was evaluated by molecular docking with two online servers: COVID-19 Docking Server and DockThor. Remdesivir was used as a control. The results showed that Cypellocarpin B, Cypellocarpin C, Luteolin 7-glucoside, and Syringetin glucopyranoside showed the highest binding energy towards Mpro and RdRp proteins with respect to Remdesivir. The comparison of molecular docking servers showed differences in the docking motors and proteins available on each server. The bioactive compounds evaluated can act as potential inhibitors against Mpro and RdRp proteins of COVID-19, according to in silico molecular docking.
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The COVID-19 pandemic established a new challenge for health services in Mexico, which is why these services faced the challenge of responding to the affected people, by providing them services with opportunity, efficiency, effectiveness and safety. The Instituto Mexicano del Seguro Social (IMSS, Mexican Institute for Social Security) gave medical attention to the larger number of affected people: towards the end of September, 2022, 3,335,552 patients were registered, who represented 47% of the total (7,089,209) of confirmed COVID-19 cases since the beginning of the pandemic in 2020. Of all the cases treated, 295,065 (8.8%) required hospitalization. In addition of new scientific evidence and the implementation of best practices in medical care and directive management (with the general objective of improvement of the processes in hospital attention, even without an effective treatment at the time), we presented an evaluation, supervision method with a comprehensive (involving the three levels of health services) and analytic (structure, process, result and directive management components) approach. The achievement of specific goals and lines of action was established in a technical guideline with health policies for the COVID-19 medical care. These guidelines were instrumented with a standardized evaluation tool, a result dashboard and a risk assessment calculator, improving the quality of medical care and directive management by the multidisciplinary health team. Copyright © 2023 Revista Medica del Instituto Mexicano del Seguro Social.
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SARS‐CoV‐2 is the causative agent of coronavirus disease 2019 (COVID‐19). The disease presents different degrees of severity related to the antiviral response of the host. According to clinical manifestations, patients could show mild, moderate and severe COVID‐19. Regarding immunological aspects, an increased interferon (IFN) response in COVID‐19 patients with mild and moderate symptoms were observed;however, in severe COVID‐19, IFN response is decreased. Patients with severe COVID‐19 display a hyperinflammatory disorder that leads to acute respiratory distress syndrome. Interestingly, the expression and activation of AIM2, a receptor induced by IFN, play an important role in the onset of antiviral response. In this review, we discuss the possible role of AIM2 during SARS‐CoV‐2 infection. We summarize the studies reporting the expression and activity of proteins involved upstream and downstream of AIM2‐inflammasome activation, such as IFN, ASC, Caspase‐1, IL‐1β, IL‐18, free‐dsDNA, IFI16, as well as SARS‐CoV‐2 viral load, cell death in groups of COVID‐19 patients with different clinical outcomes to infer the possible contribution of AIM2 in antiviral response of SARS‐CoV‐2 infection.
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INTRODUCTION: An impacted population of the COVID-19 pandemic is those with limited English proficiency (LEP). Due to visitor restrictions, caregivers were unable to facilitate communication with hospital staff, and those with LEP were more susceptible to poor communication with their healthcare providers. METHOD(S): Data was ed from the BIDMC site of the SCCM VIRUS Discovery Database, a de-identified, HIPAA-compliant database containing clinical information for COVID-19 patients admitted to BIDMC. Patients were placed into two groups, either requiring translator services for any language or not. Statistical analyses were performed in R Version 3.0 to calculate test statistics such as ANOVA and Chi-Square p-values. The primary outcome assessed length of stay (LOS). Secondary outcomes included complications, discharge status of alive or deceased, discharge location of either home or another care facility, and number of symptomatic days before hospital admission. The association between non-White, non-Hispanic demographics and need for translation services was also examined. RESULT(S): 1522 patients were included with 91 excluded due to unknown use of translator services. The relationship between the requirement of an interpreter and LOS, complications, and symptomatic days was not statistically significant. However, statistically significant findings include patients who required translational services were more likely discharged alive (OR 1.53, 95% CI 1.07-2.24), and discharged to their homes (OR 1.42, 95% CI 1.07-1.91). Use of translator services was strongly associated with minority status (OR 5.20, 95% CI 3.81-7.21). A limitation of this dataset is that deceased status is only recorded if the patient dies during the index visit, potentially missing those who expire from COVID-related complications post-discharge. CONCLUSION(S): The requirement of a translator was not correlated with longer hospital stays, more complications, or days symptomatic prior to admission in comparison to the patients' English-speaking counterparts. However, the use of a translator was positively correlated with survival, discharge home, and minority status. The increased odds of discharge home could be due to the cultural values of minorities providing care in a familial setting.
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INTRODUCTION: Racism has been identified as a driver of health disparities. The COVID pandemic has widened the gap between Whites and racial minorities, resulting in an even greater burden of disease and poorer health outcomes. The Boston area has a greater wealth disparity between these groups compared to the national average. We hypothesize that African American and Hispanic groups in the Boston Area have carried a greater burden of severe disease compared to Whites. METHOD(S): This cross-sectional study included 1,272 single-event adults admitted to Beth Israel Deaconess Medical Center (Boston, MA) due to COVID from March 2020 to April 2022. Patients were grouped by demographics captured in the medical records. Three groups were determined to have the appropriate sample sizes for analysis: Hispanics of any race, African American Non-Hispanics, and White Non-Hispanics. The primary outcome assessed was ICU admission rates;secondary analyses included length of hospitalized and ICU stay and comorbidity rates. Statistical analyses were performed in R Version 3.0. RESULT(S): Out of our sample, 31% were African American (AA), 20% Hispanic, and 49% White. Compared to Whites, ICU admission rates for AA patients were higher than for Hispanics, with an odds ratio (OR) of 1.45 (95% CI, [1.11,1.91]) and 1.21 [1.27, 1.64], respectively. When adjusting for sex, age, and comorbidities, the same pattern was observed: ICU admission rates for AAs were positively associated for both males (1.64, [1.11,2.43] and females (1.19, [1.04,1.36]), but only for Hispanic females (1.44, [1.05,1.97]). AAs and Hispanics had a significantly higher OR of having 3+ comorbidities (1.3, [1.13,1.72] and 1.47 [1.12, 1.96]). CONCLUSION(S): Ethnic minority groups have suffered a disproportionately greater burden of disease related to COVID. Our study shows that ICU admission was positively associated with AA and Hispanic race, opposite to what had been previously shown in some publications. Our findings could help reorient public health measures to improve health outcomes in these populations.
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Coronaviruses (CoVs) belong to a group of positive-sense single-stranded RNA viruses that have the largest genome known for a virus and use RNA as its genetic material. These viruses can infect a wide variety of animals, causing very different diseases that include common cold (humans), peritonitis (cats), hepatitis (mouse), and life-threatening pneumonia (humans). In fact, before the year 2002, most of the CoV literature focused on viruses of veterinarian interest. This changed in 2002 and 2012 with the appearance of two novel human CoVs that cause Severe Acute Respiratory Syndromes, SARS-CoV and MERS-CoV, respectively. The localized epidemics caused by these two viruses served as warning events on how zoonotic transmission of CoVs between bats (or camels) and humans could result in the formation of new viruses. Unfortunately, the research on these viruses mostly caught only the attention of the groups that either previously worked with CoVs of veterinarian interest or lived in the regions affected by SARS-CoV and MERS-CoV. © 2022 Elsevier Inc. All rights reserved.
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Purpose : Since the onset of the coronavirus disease 19 (COVID-19) pandemic, people's lives have adapted, with the use of face masks becoming a part of our daily routine. Despite being a useful device to prevent disease contagion, a marked increase in dry eye and stye symptoms has been detected. We aimed to perform an observational correlation analysis between face-mask use and to report both objective and subjective ocular surface measurements performed on a multi-purpose advanced corneal topographer and a high-definition camera. Methods : This study included 25 healthy subjects without any ocular diseases, ages ranging from 19 to 68 years. We measured tear meniscus height, Non-Invasive Tear Breakup Time (NIBUT), overall redness score, and tear film lipid layer characterization using Keratograph 5M (Oculus, Wetzlar, Germany), as well as Ocular Surface Disease Index (OSDI) scores for dry eye symptomatic assessments. Patients were asked the number of hours of mask-use at the moment of enrollment, the average hours of mask use daily, and the type of face mask used. We assessed for differences between OSDI scores and gender and type of mask used, as well as correlation coefficients for all subjective and objective measurements. Results : The mean age of the subjects was 42.44±14.49 years. OSDI scores had no significant differences according to gender (p = 0.1664) or type of mask used (p = 0.0791). Correlation between hours of mask use at the time of testing and ocular surface modifications were minimal. Hours of mask-use at the time of the test and OSDI scores were moderately correlated (r= 0.5047, p=0.01). No correlation was found between the average hours of mask use and any ocular surface measurements or OSDI scores. Conclusions : The use of face masks increased subjectively dry eye symptoms. Nevertheless, ocular surface objective measurements remain unchanged by maskwearing.
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Background: Patients requiring extracorporeal membrane oxygenation (ECMO) frequently necessitate tracheostomy due to prolonged mechanical ventilation. SARS-CoV-2 infection has been associated with different coagulation disorders and may increase the risk of bleeding in high risk patients such as those requiring ECMO. Here, we aim to determine if SARS-CoV-2 increases the risk of bleeding after tracheostomy in ECMO patients. Methods: A retrospective review of all patients requiring ECMO at our institution between March 20 of 2020 and December 31 of 2021 was conducted. Patients requiring tracheostomy after ECMO were included. Demographics, COVID-19 status, tracheostomy approach and post-procedure bleeding events were collected. Statistical analysis was performed using student T-test for nominal variables and Chi-Square test for categorical variables. Results: A total of 267 patients required ECMO during the defined study period. Of these, 112 patients had tracheostomy placement and were included for analysis. Seventy-five percent (84/112) of tracheostomies were done percutaneously and 25% (28/112) were done using surgical open technique. Mean age was 46.2 years ±14.3, 68% were male, mean BMI was 29.9Kg/m2 ±5.5. Seventy patients (63%) had COVID-19. The remaining 42 (37%) required ECMO due to polytrauma, cardiogenic shock, and respiratory failure after other operations such as heart and lung transplant. Of the 112 tracheostomies performed, 34% (38/112) had severe bleeding after tracheostomy placement requiring blood transfusion or additional interventions to control the bleeding. Of the 70 patients with COVID-19, 47% had severe bleeding compared to 12% in the non-COVID-19 group (p=<0.001) (Table). Conclusion: The rate of severe bleeding after tracheostomy was significantly higher in patients with COVID-19 compared with those that did not have SARS-CoV-2 infection. COVID-19 status should be considered before tracheostomy in ECMO patients as it may increase the risk of bleeding complications (Table Presented).
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During the time of the Covid 19 pandemic, the behavior of three human groups was analyzed after having completed the 16-week academic semester in September 2020. The students of each human were divided into 4 resulting quadrants, the attitudinal behavior was weighted on the axis of the abscissa and the axis of the ordinates to the final grade. The students of each one of the groups were distributed applying their percentage value within each one of the quadrants, those that are denominated talented, responsible, confident, disinterested, being their averages 18.27%, 37.69%, 13.09% and 30.99% respectively. It was demonstrated that there is no significant difference between the three groups, in terms of the percentage values assigned to each of the quadrants, as well as that there is no significant difference between the percentage values between the quadrants of the talented and the confident, nor between the responsible and the disinterested.
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Background: COVID-19 has increased interest and uptake of mental health apps. As healthcare payers consider reimbursement for some apps and creation of app formularies, questions remain about the state of these apps and how to judge their value. As apps are not static and constantly changing and updating, we investigated the dynamics of the app marketplaces to better understand their privacy, efficacy, and safety features in the 'real world'. Methods: A sample of 250 apps were reviewed between September 1st 2021 and December 1st 2021. Apps were selected from mindapps. org based on their age of last review on mindapps.org, with apps approaching six months since being updated in this database reviewed first. Mindapps.org is the world's largest free-to-access database of mental health apps that currently curates 650 apps each rated across 105 dimensions. For this study, each of the 250 apps were again reviewed across 105 dimensions and results were compared to changes from the prior rating of the same app ∼6 months ago. Results: The average app updates every 364 days although some nearly weekly. Privacy features changed the most since the last update with 38% of apps reflecting a change. 37% of apps changed in regards to features offered with the most common change as adding physical exercise related content to the apps. Functionality and access changed in 27% of apps with the most common change being increase in accessibility features as well as offering offline access to the app. 20% of apps changed their cost structure with 12% adding a fee for use of the app. Reviewers noted that ads to support apps were in some cases intrusive. Discussion: The dynamic nature of the app stores is reflected in app privacy, features, and functionality. For payers to be able to offer app formularies, they need to create metrics to assess these changes in the app landscape or else tightly control app updates themselves. Other aspects necessary for valuation such as real-world engagement with the apps as well as mean effect size are not publicly available and thus not reported in our results. To truly understand the economic value of mental health apps, dynamic pricing models combined with transparency in data reporting from apps will be necessary.
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Background: Asymptomatic subjects, the lack of diagnostic tests and, in countries like Mexico, the epidemiological surveillance method does not allow to establish the real number of infections in the COVID-19 pandemic. Frontline health personnel, as well as other groups related to priority activities are considered of high risk. We included administrative workers in contact with health personnel in the hospital units of the Mexican Institute for Social Security (IMSS, according to its initials in Spanish). Objective: To identify the seroprevalence of antibodies to SARS-CoV-2 in IMSS' administrative staff who does not treat patients. Material and methods: 76 volunteer participating individuals were incluided;IgG antibodies against the SARS-CoV-2 nucleoprotein were measured. A questionnaire was administered to the participants in order to identify possible risk factors. Results: 76 participants were included (39 men, 51.7%), with a median age of 42 years. 29 out of 76 subjects (38.2%), whose median age was 38 years (range 18-69 years);15 men (51.7%), and 14 women (48.3%). A higher percentage of positive subjects under 45 years of age (n = 20, 84.2%) was observed than those aged 45 or over (n = 9, 25%), with an OR of 3 (95% CI 1.13-7.96, p = 0.03). No statistically significant difference was found regarding the type of comorbidity. Conclusions: The prevalence identified shows an important circulation of the virus in the administrative staff.
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Public procurement has not been an exception to the economic crisis resulting from Covid-19. The instability derived from the state of alarm is particularly serious in the case of catering services linked to the public sector. In order to mitigate the damage caused to service concessions, art. 34.4 of Royal Decree-Law 8/2020, 17th March, introduced an exceptional regime so as to restore the economic equilibrium of contracts from which more doubts than certainties have arisen. The aim of this work is to provide the legal operator with a series of answers that will enable him to duly channel the effective exercise of the service concessionaire's right to compensation. And this, in a productive sector as affected as the catering sector, or even doubly affected, as is the case of university cafeterias and canteens. © 2022, Iustel. All rights reserved.
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Comparing the countries' level of preparedness and response to the Covid-19 pandemic involves the assessment of human development, health, connectivity and death rate indicators. In this study, information published by the United Nations Development Program (UNDP) and the World Health ]Organization (WHO) was used to assess the performance of 148 countries classified as either of the Global South (Africa, Latin America and Asia-Oceania) or the Global North, describing how the unequal social and health conditions between regions are reflected in terms of contagion and death figures at year-end 2020. The HJ-Biplot multivariate technique was used to simultaneously represent both the countries and the indicators, providing a descriptive and exploratory analysis of how the countries' level of preparedness to face the pandemic in terms of health and human development did not determine their success in reducing Covid-19 contagion and death rates, because success also depends on efficient and quick government action and reaction strategies.
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Introduction: In 2020, an exponential growth and accelerated expansion of COVID-19 was observed. Cuba had 20 hospitals ready for medical care, some 5,000 hospital beds and 477 intensive therapy beds. Objective: Describe the cost of the main assistance and logistics assurance services during the response to COVID-19. Methods: A descriptive and prospective study was carried out in 363 patients, between March 12 and May 30, 2020. The variables studied were patient-day, bed-day, medications, medical supplies, food, clothing, cost per salary and energy power consumed. To obtain the total cost of a patient-day, the fixed and variable costs were added, expressed in Cuban pesos CUP. Results: In the COVID-suspects patient ward, a high number of patient-day (14 578) and a low number of bed-day (5 976) were observed. The average cost per salary was higher in nursing (226,2 CUP). Medications generated at high cost (35,6 %). In April, the highest electricity consumption was recorded (36,6 %) and a cost of 18,071.1 CUP. In relation to the total number of patient-day, an increase in fixed costs (87,30 %) was observed over the variables. Conclusions: The analysis of the cost of patient day-during the COVID-19 pandemic allowed to detail, by hospitalization wards, how much the expenses vary between healthcare services and logistics assurance, as well as the differences between fixed and variable costs. © 2021, Editorial Ciencias Medicas. All rights reserved.
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The Undergraduate Student Instrumentation Project (USIP) was a NASA program created to engage undergraduate students in rigorous scientific research for the purposes of innovation and developing the next generation of professionals in space research. It is now run by the University of Houston using local resources. This student-led project, based on the 5E instructional model, is executed by the students from initial ideation of research objectives to the design, testing, and deployment of scientific payloads. The 5E Instructional model places the student at the center of knowledge building, while instructors facilitate interaction with content and guide the inquiry process. Since 2013, this project has been not only an effective vehicle for delivering STEM education but is also effective in increasing classroom engagement and interest in space. Space research is inherently interdisciplinary and crosscuts Geoscience, Engineering, and Technology. The project is designed to integrate engineering, technology, physics, material science, and earth and atmospheric sciences as an important opportunity for the students to gain access to cross-disciplinary experiential research. In addition to classroom engagement, the students build their own payloads and ground instruments. This project increases students’ command of essential skills such as teamwork, collaboration, problem solving, technology, communication, innovation, and leadership. For the faculty, the project was an extended exercise in professional development, learning how to implement project level inquiry-based education on this scale. For the students, this formative experience continues to encourage the development of a much broader range of technical skills than is typically offered within an undergraduate degree. Furthermore, the extensive time and energy that students commit to this project promotes a strong sense of personal and professional responsibility and emphasizes the necessity of coherent teamwork. Not only do students make valuable connections with each other during this process, but also to the broader space science community. They often work with professionals from outside of the USIP structure, and regularly attend and present at conferences and student competitions throughout the project. This paper will present a web-based scaffolding used to simulate the traditional face to face 5E experience during COVID. Student projects have included subjects ranging from atmospheric trace gas chemistry, LiDAR study of snow and sand avalanche dynamics, auroral electron precipitation, gravity wave modulation of the hydroxyl layer, search for stratospheric microplastics, and monitoring auroral radio emissions, among others. This program is a for-credit course of two to three years duration. Copyright © 2021 by the International Astronautical Federation (IAF). All rights reserved.
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Background. Patients with severe SARS-CoV-2 infection are at high risk of complications due to the intensive care unit stay. Hospital-acquired infections (HAI) are one of the most common complication and cause of death in this group of patients, it is important to know the epidemiology and microbiology of this hospital-acquired infections in order to begin to the patients a proper empirical treatment. We describe the epidemiologic and microbiologic characteristics of HAI in patients with COVID-19 hospitalized at intensive care unit (ICU) in a tertiary level private hospital in Mexico City. Methods. From April to December 2020, data from all HAIs in patients with severe pneumonia due to SARS-CoV-2 infection with mechanical ventilation at ICU were obtained. The type of infection, microorganisms and antimicrobial susceptibility patterns were determined. Results. A total of 61 episodes of HAIs were obtained, the most common was ventilator associated pneumonia (VAP) in 52.4% (n=32) followed by urinary tract infection (UTI) 34.4%(n=21) and bloodstream infection (BSI) 9.84% (n=6). Only two episodes corresponded to C. difficile associated diarrhea. We identified 82 different microorganisms, the most frequent cause of VAP was P. aeruginosa 22% (10/45) followed by K. pneumoniae 20% (9/45);for UTI, E. coli 28.5% (6/21), and S. marcescens 19% (4/21);for BSI the most frequent microorganism was S. aureus 28.5 (2/7). Regarding the antimicrobial susceptibility patters the most common were Extended Spectrum Beta-Lactamase (ESBL) Gram-negative rods followed by Methicillinresistant Staphylococcus aureus. Conclusion. In patients with severe COVID-19 hospitalized in the ICU the most frequent HAIs were VAP and UTI caused by P. aeruginosa and E. coli respectively. ESBL enterobacteriaceae was the most common resistant pattern identifed in the bacterial isolations in our series.